Active NPI
Avis Jackson
- Clinical Social Worker
- Natchitoches, LA
National Provider Identifier
1396309399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11061
- Practice address
- 714 Oakland Dr
Natchitoches, LA 71457-5626 - Phone
- (318) 228-5396
- NPI assigned
- Apr 24, 2019
- Last updated
- Apr 24, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11061 | LA | Primary |
Addresses
Primary practice location
714 Oakland Dr
Natchitoches, LA 71457-5626
Mailing address
714 Oakland Dr
Natchitoches, LA 71457-5626
Phone (318) 228-5396
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1396309399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 OAKLAND DR",
"city": "NATCHITOCHES",
"state": "LA",
"postal_code": "714575626",
"telephone_number": "318-228-5396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 OAKLAND DR",
"city": "NATCHITOCHES",
"state": "LA",
"postal_code": "714575626",
"telephone_number": "318-228-5396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "AVIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-24",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "11061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Natchitoches, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.